The dacryoscanner, an optimal technique for nasolacrimal system exploration. / Le dacryoscanner, une technique optimale d'exploration des voies lacrymo-nasales.

The dacryoscanner is the imaging technique of choice in case of persistent tearing. It allows the opacification of nasolacrimal system, and thus determines the site and the origin of obstruction. The site could be the lacrimal canaliculus, the lacrimal sac, or the nasolacrimal duct. The origin could be an idiopathic or a sequellar stenosis, a dacryolithiases, a bony malformation, or a tumor. This is a technique done by the radiologist under aseptic conditions, and easily tolerated by the patient. Many technical variants exist for an optimal opacification of the nasolacrimal system.

[Immediate hypersensitivity reactions to iodinated contrast agents used in radiology: a review]. / Mise au point sur les réactions d'hypersensibilité immédiate aux produits de contraste iodés (PCI).

The use of iodinated contrast agents (IC) has become common practice nowadays in the daily diagnostic and therapeutic procedures in radiology. Immediate hypersensitivity reactions occurring up to the first hour after injection of IC, can be of serious consequences, occasionally leading to death. This justifies the establishment of a prevention algorithm, including a sharp identification of those at risk and the implementation of premedication with corticosteroids. A history of previous reaction to IC is the major risk factor of a new reaction. Other risk factors include asthma, atopy and cardiomyopathy. The factors that influence the severity of the hypersensitivity allergic reactions are female gender, age, and taking beta blockers or ACE inhibitor drugs.

Ultrasound as an adjunct to radiography in minor musculoskeletal pediatric trauma.

PURPOSE: To assess the value of ultrasound as an adjunct to radiography in minor musculoskeletal pediatric trauma. METHODS: Fifty children with 53 suspected fractures were referred for upper and/or lower limbs X-rays, followed by ultrasound. On radiography, we noted presence of fracture, of soft tissue thickening, or absence of any lesion. On ultrasound, we noted presence of fracture, of soft tissue lesion, or absence of lesions. RESULTS: A fracture was seen on both examinations in 25 patients with 28 fractures.In 4 patients where only soft tissue thickening was seen on radiography, ultrasound showed fracture in 1 patient, hematoma in 1 patient and was normal in 2 patients. In another patient with a doubtful diagnosis of fracture on radiography, ultrasound was normal. In 20 patients with normal X-rays, ultrasound showed fracture in 6 patients, hematoma in 7 patients and was normal in 7 patients. CONCLUSION: Ultrasound was helpful as an adjunct to radiography, it yielded additional bone (7/50 patients) and soft tissue (8/50 patients) diagnostic information in 30% of patients. However, ultrasound remains operator-dependent and can be used only in particular circumstances, especially in children with normal X-rays and a high index of clinical suspicion for an occult or subradiological fracture.

[Anatomy of the larynx with 64-channel multidetector CT]. / Anatomie du larynx au scanner 64 canaux.

Knowledge of axial anatomy of the different laryngeal structures, identification of the plan of the cords, and relations between the true and false vocal cords is essential for laryngeal surgery where anatomical and radiological correlation is necessary for optimal orientation and guidance. This review constitutes an atlas of axial anatomy of the larynx obtained from a multidetector CT scan, describing the skeletal cartilage, the different folds constituted by laryngeal ligaments covered by mucosa, and the fatty laryngeal spaces. It shows that CT scan and the different reconstructions specifically virtual endoscopy are a valuable adjunct in laryngeal exploration.

Originality of new imaging techniques in pediatric radiology.

Pediatric radiology is a specialty that combines the performances of imaging and radio-protection. It also has to deal with absence of cooperation and motion of the child which have limited for a long time many radiological applications. Technical advances with shorter acquisition time in CT and MRI, higher frequencies in ultrasound, and digitalization in conventional radiology have widened the indications especially with the new modalities. We present in this article the originalities and the benefits of current pediatric radiology and perform a historic review outlining its evolution.

[The echocardiographic interpretation of musculoskeletal disease pathology in children]. / Intérêt de l'échographie dans les pathologies musculo-squelettiques en pédiatrie.

Osteoarticular ultrasound, a well established technique in adults, appears to be very useful also in children because of the non ossification of cartilaginous structures, the possibility to avoid sedation and irradiation, and hence the use of scanner and MRI will be reduced. This is a review of the clinical applications of musculoskeletal ultrasound in the pediatric population. Pictorial examples of cases collected between January 2003 and December 2006 of different pathologies encountered in Lebanon are displayed with a discussion of congenital malformations, traumatic lesions, inflammatory and infectious lesions, bone dystrophy and dysplasia, metabolic and tumoral lesions.